Tips for saving money on prescriptions

By Peggy Noonan If you've picked up a prescription lately, you already know prescription prices--and co-payments for people with insurance--are on the rise.According to a Kaiser Family Foundation report, prescription drug costs quadrupled between 1990 and 2002, when prescription drug spending in America reached $162.4 billion. Many health insurance plans have responded to these higher prices by creating cost-sharing programs - deductibles, coinsurance or co-payments, and benefit caps.Health plans push patients toward lower cost drugs in several ways: Making generic substitutions mandatory. Your doctor may write a prescription for the blood pressure medicine Toprol XL, but if your insurance restricts you to generic only, you'll get the generic metoprolol succinate instead. Limiting prescriptions to a certain list. An insurance company's formulary is a list of drugs the plan has approved (they may have a price-cutting arrangement with the manufacturer). If Toprol XL is on your plan's formulary, you can have it. If it's not, you may get the beta blocker drug on the formulary. Requiring patients to get prescriptions by mail order. Charging higher co-payments for more expensive drugs. What can you do to get co-payment costs under control? Talk to your doctor about what's coveredOnly about a third of doctors discuss cost when they give patients a new prescription. Your doctor may already know what's covered by major insurance plans in your area, but if there's any doubt, she can phone the insurance company to be sure the medicine will be covered. Your pharmacist also can help with information on your plan's available drugs and their alternatives. Look into cost-cutting programsPeople taking cancer drugs may be eligible for Amgen Oncology Assistance, a comprehensive financial assistance program that caps co-payment costs for patients taking the cancer drug Vectibix.There are also patient assistance programs (PAP) and prescription discount programs like the Patient Partnership for Prescription Assistance , The Medicine Program.com , and Rx Outreach that provide low-cost prescriptions to patients who qualify. Financial and other restrictions may apply. Buy prescriptions online or at discount storesThe Internet is a great place to comparison-shop for medications. One place to do this is DestinationRx . Type in the name of a drug. Verify the name and select the quantity you need. You'll get a list of reputable pharmacies that sell the drug. You'll see the price for refills, along with the cost of shipping. DestinationRx also lists lower-cost alternatives to brand name drugs.You may need to register to access some features. Also, some discount stores, including Wal-Mart and Target charge $4 for many generics (both these links go to PDF files). Cut or combine medsAsk your doctor if you still need to take all of your prescription drugs. If not, you could drop one or more prescriptions, or take a lower dose. Or, if you're taking more than one medication, ask if there's a combination drug you could take instead. In some cases, one pill can do the work of two.Are you taking one drug to counteract the side effects of another drug? If the drug that causes the side effect can be changed to one that doesn't cause that problem, you'd need one less prescription. Ask if there's a generic or over-the-counter alternativeIf you're currently taking a brand name drug, a less expensive generic may give you the same benefit for a much lower price. Your pharmacist will know if a generic formula is available. Also, some medications that were once only available by prescription-such as the heartburn drugs Prilosec, Zantac, and Pepcid--are now sold over-the-counter. OTC drugs may be a good choice if you're close to maxing out your coverage benefits or if the co-pay is lower for OTC medications. Ask about pill-splittingFor some drugs such as cholesterol-reducing statins, splitting tablets and talking half-dose may save money. For example, if you're taking a 20 mg tablet daily, you may be able to get your doctor to prescribe the 40 mg size so you can split the tablets and take a half tablet (20 mg) each day. That way, you'd make one co-payment instead of two to get the same amount of medicine. Try samples of new medicationsBefore paying for a prescription of a new medication, ask your doctor for a sample. That way you can be sure you tolerate a new drug well before you pay for a prescription.These ideas should help you save money on prescription co-pays and the cost of medications in general.  Read full story >